基于 MRI 的深度学习模型对淋巴结阴性浸润性乳腺癌淋巴管血管侵犯状态的预测价值。
Predictive value of MRI-based deep learning model for lymphovascular invasion status in node-negative invasive breast cancer.
机构信息
Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, West Huan-Hu Road, Ti Yuan Bei, Hexi District, Tianjin, 300060, People's Republic of China.
Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, People's Republic of China.
出版信息
Sci Rep. 2024 Jul 13;14(1):16204. doi: 10.1038/s41598-024-67217-0.
To retrospectively assess the effectiveness of deep learning (DL) model, based on breast magnetic resonance imaging (MRI), in predicting preoperative lymphovascular invasion (LVI) status in patients diagnosed with invasive breast cancer who have negative axillary lymph nodes (LNs). Data was gathered from 280 patients, including 148 with LVI-positive and 141 with LVI-negative lesions. These patients had undergone preoperative breast MRI and were histopathologically confirmed to have invasive breast cancer without axillary LN metastasis. The cohort was randomly split into training and validation groups in a 7:3 ratio. Radiomics features for each lesion were extracted from the first post-contrast dynamic contrast-enhanced (DCE)-MRI. The Least Absolute Shrinkage and Selection Operator (LASSO) regression method and logistic regression analyses were employed to identify significant radiomic features and clinicoradiological variables. These models were established using four machine learning (ML) algorithms and one DL algorithm. The predictive performance of the models (radiomics, clinicoradiological, and combination) was assessed through discrimination and compared using the DeLong test. Four clinicoradiological parameters and 10 radiomic features were selected by LASSO for model development. The Multilayer Perceptron (MLP) model, constructed using both radiomic and clinicoradiological features, demonstrated excellent performance in predicting LVI, achieving a high area under the curve (AUC) of 0.835 for validation. The DL model (MLP-radiomic) achieved the highest accuracy (AUC = 0.896), followed by DL model (MLP-combination) with an AUC of 0.835. Both DL models were significantly superior to the ML model (RF-clinical) with an AUC of 0.720. The DL model (MLP), which integrates radiomic features with clinicoradiological information, effectively aids in the preoperative determination of LVI status in patients with invasive breast cancer and negative axillary LNs. This is beneficial for making informed clinical decisions.
回顾性评估基于乳腺磁共振成像(MRI)的深度学习(DL)模型在预测术前腋窝淋巴结阴性(LNs)浸润性乳腺癌患者的术前淋巴血管侵犯(LVI)状态的有效性。数据来自 280 名患者,其中 148 名 LVI 阳性,141 名 LVI 阴性病变。这些患者均接受了术前乳腺 MRI 检查,并经组织病理学证实为无腋窝 LN 转移的浸润性乳腺癌。该队列以 7:3 的比例随机分为训练组和验证组。从每个病变的第一个对比后动态对比增强(DCE)MRI 中提取放射组学特征。采用最小绝对收缩和选择算子(LASSO)回归方法和逻辑回归分析来识别显著的放射组学特征和临床放射学变量。使用四种机器学习(ML)算法和一种 DL 算法建立这些模型。通过 DeLong 检验比较评估模型(放射组学、临床放射学和联合)的预测性能。LASSO 选择了四个临床放射学参数和 10 个放射组学特征用于模型开发。使用放射组学和临床放射学特征构建的多层感知器(MLP)模型在预测 LVI 方面表现出色,验证时获得了较高的曲线下面积(AUC)为 0.835。DL 模型(MLP-放射组学)的准确率最高(AUC=0.896),其次是 DL 模型(MLP-联合),AUC 为 0.835。这两个 DL 模型均显著优于 AUC 为 0.720 的 ML 模型(RF-临床)。DL 模型(MLP)整合了放射组学特征和临床放射学信息,有效帮助术前确定腋窝淋巴结阴性浸润性乳腺癌患者的 LVI 状态,为临床决策提供参考。